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Intraventricular HemorrhageiF-MOM-IVHNCT07812922

Intranasal Fresh Mother's Own Milk to Prevent Intraventricular Hemorrhage in Extremely Preterm Infants

A study testing Intranasal Fresh Mother's Own Milk (iF-MOM) in people with Intraventricular Hemorrhage and Premature Birth, run by University of Manitoba.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

Babies born very prematurely are at risk of intraventricular hemorrhage (IVH), which is bleeding in or around the fluid-filled spaces of the brain. Most IVH occurs during the first week after birth. Read more about this study

Who is it for?
Ages 0 to 72 hours
Conditions the study is for
Intraventricular Hemorrhage, Premature Birth
What is being tested?
Intranasal Fresh Mother's Own Milk (iF-MOM)
Could I receive a placebo?
No, everyone receives an active treatment
How many people
67 participants
Where
No sites listed yet
Study dates
Oct 2026to Apr 2028
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 0 to 72 hours
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Gestational age ≤29+0 weeks based on the best obstetric estimate, with first-trimester ultrasound preferred.
  • Inborn at Women's Hospital or St. Boniface Hospital, Winnipeg, Manitoba, Canada.
  • Written informed consent obtained from a parent or legal guardian; antenatal consent may be obtained when preterm delivery is anticipated.
  • Mother/birthing parent intends and is able to provide fresh own milk for study dosing; low initial milk volume is acceptable because of the small intranasal dosing requirements.
  • Enrollment within 72 hours of life.

Who cannot join

  • Major congenital brain malformation, including holoprosencephaly, lissencephaly, schizencephaly, severe primary hydrocephalus, large arachnoid cyst, or other space-occupying lesion.
  • Airway or nasal anomaly precluding intranasal administration, including choanal atresia/stenosis, severe cleft palate/lip with nasal involvement, or Pierre Robin sequence with severe obstruction.
  • Trisomy 13, Trisomy 18, or another severe chromosomal/genetic disorder.
  • Acute surgical condition requiring immediate intervention, such as esophageal atresia with tracheoesophageal fistula.
  • Life-limiting condition, including comfort-care designation, anticipated survival <72 hours, known lethal diagnosis such as bilateral renal agenesis or anencephaly, or severe birth asphyxia with anticipated poor neurologic outcome.
  • Maternal contraindication to lactation, including HIV, or inability/unwillingness to provide fresh mother's own milk.
  • Evidence of Grade III-IV intraventricular hemorrhage on cranial ultrasound before enrollment.
  • Absence of fresh own-mother/birthing-parent milk for study dosing, including circumstances in which only donor or surrogate-provided milk is available.

Trial locations and contacts

No sites are listed yet. Contact the study team or a site near you to ask about taking part.

Michael Narvey contact

204-899-6845

mnarvey@hsc.mb.ca

About this study

Official title: Intranasal Fresh Mother's Own Milk (iF-MOM) for Prevention of Intraventricular Hemorrhage in Extremely Preterm Infants ≤29 Weeks' Gestational Age: A Prospective, Nonrandomized Interventional Study With Propensity Score-Weighted Historical Controls

Babies born very prematurely are at risk of intraventricular hemorrhage (IVH), which is bleeding in or around the fluid-filled spaces of the brain. Most IVH occurs during the first week after birth. Human colostrum and early breast milk contain growth factors, neurotrophic factors, immune-modulating substances, antioxidants, and other biologically active components that may have neuroprotective effects.

This study will evaluate whether giving very small amounts of a baby's own mother's fresh breast milk as nasal drops during the first 7 days of life may help prevent IVH in infants born at 29 weeks' gestation or earlier.

Read more

Approximately 67 eligible infants will be enrolled prospectively at Women's Hospital and St. Boniface Hospital in Winnipeg, Manitoba, Canada. At each scheduled study care session, fresh mother's own milk will be administered intranasally at 0.2 mL per nostril (0.4 mL total) before routine nursing care and, if tolerated and the infant remains clinically stable, repeated after care. Thus, a completed care session provides up to 0.8 mL. Study administration will be coordinated with 2-4 routine care sessions per day for 7 consecutive days, corresponding to a planned total daily volume of 1.6-3.2 mL.

The main study outcome is whether IVH of any grade is present on the routine cranial ultrasound performed at 4 to 7 days of life. Other outcomes include severe IVH, progression of IVH, post-hemorrhagic ventricular complications, mortality before hospital discharge, and the safety and tolerability of intranasal mother's own milk.

Outcomes in the prospectively treated infants will be compared with those of eligible infants previously cared for at the same neonatal intensive care units between 2020 and 2025. Statistical methods using propensity score weighting will be used to account for measured differences between the prospectively treated infants and the historical comparison group.

Read the detailed description

Intraventricular hemorrhage (IVH) remains an important complication of extreme prematurity and occurs predominantly during the first postnatal week. The immature germinal matrix vasculature, impaired cerebral autoregulation, hemodynamic instability, inflammation, oxidative stress, and other factors contribute to vulnerability to hemorrhage in extremely preterm infants.

Fresh colostrum and early mother's own milk contain multiple biologically active constituents with potential neuroprotective effects, including growth factors, neurotrophins, anti-inflammatory and immune-modulating mediators, antioxidants, and other bioactive components. Intranasal administration is being evaluated as a non-invasive route that may permit exposure of the central nervous system to milk-derived bioactive factors through proposed olfactory, trigeminal, perineural, and perivascular pathways.

This is a prospective, nonrandomized interventional study conducted at Women's Hospital and St. Boniface Hospital in Winnipeg, Manitoba, Canada. Eligible inborn infants at 29+0 weeks' gestation or less will be prospectively enrolled within 72 hours of birth. Enrolled infants will receive intranasal fresh mother's own milk during the first 7 days of life.

Fresh milk from the infant's own mother or birthing parent will be used. Milk used for study dosing will not be refrigerated or frozen before intranasal administration and will be used within 3 hours of expression. Each study dose consists of 0.2 mL administered into each nostril, for a total of 0.4 mL per dose. Doses will be administered 2 to 4 times daily for 7 consecutive days, coordinated with routine nursing care when possible. Clinical feeding and oral immune therapy needs will take priority over study dosing.

Infants will remain on continuous cardiorespiratory monitoring and pulse oximetry. Safety assessments will be performed during dosing and for at least 60 minutes after each administration. Study dosing may be delayed, withheld, or stopped if prespecified clinical instability or safety concerns occur.

The primary outcome is the presence of any IVH, Papile Grades I-IV, on cranial ultrasound performed at 4 to 7 days of life. Secondary outcomes include severe IVH, progression of IVH on subsequent imaging, post-hemorrhagic ventricular complications requiring intervention, all-cause mortality through hospital discharge, and safety and tolerability outcomes related to intranasal administration.

The study will enroll approximately 67 prospectively treated infants. Their outcomes will be compared with those of up to 188 historical controls admitted to the same two neonatal intensive care units between January 1, 2020 and December 31, 2025. Historical controls will meet the prespecified eligibility criteria and must have a documented cranial ultrasound at 4 to 7 days of life.

Because participants are not randomized to a concurrent control group, propensity scores will be estimated using prespecified maternal and neonatal characteristics. Stabilized inverse probability of treatment weighting and weighted regression methods will be used to reduce measured baseline imbalance between the prospectively treated infants and historical controls. The primary cranial ultrasound outcome will be assessed by a reviewer blinded to intervention versus historical-control status.

An optional mechanistic sub-study will permit storage and analysis of small leftover aliquots of study milk from Day 1 and Day 7, when sufficient milk remains after clinical and study dosing requirements are met. These samples will be used for approved analyses of selected naturally occurring milk components, including growth factors and neurotrophins.

Being tested
Intranasal Fresh Mother's Own Milk (iF-MOM)
Keywords
Extremely Preterm Infant, Intraventricular Hemorrhage Prevention, Germinal Matrix Hemorrhage, Intranasal Human Milk, Mother's Own Milk, Breast Milk, Neonatal Neuroprotection, Preterm Brain Injury, Colostrum, iF-MOM
Medical subject headings
Premature Birth

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Intranasal Fresh Mother's Own Milk (iF-MOM)Other

    Fresh breast milk from the infant's own mother/birthing parent will be administered intranasally. The initial volume is 0.2 mL into each nostril (0.4 mL total per administration). If tolerated, the volume may be increased to 0.4 mL into each nostril (0.8 mL total per administration). Administration will occur 2-4 times daily for 7 consecutive days. Milk used for study dosing will be fresh from expression, maintained at room temperature, never refrigerated or frozen before administration, and used within 3 hours of expression.

Study groups in NCT07812922
Study groupRoleWhat they receive
iF-MOM InterventionExperimentalEligible extremely preterm infants born at ≤29+0 weeks' gestation will receive intranasal fresh mother's own milk (iF-MOM) in addition to standard neonatal intensive care. The initial administration volume is 0.2 mL per nostril (0.4 mL total). If tolerated without a clinically significant administration-related adverse event, the volume may be increased to 0.4 mL per nostril (0.8 mL total) at the discretion of the treating/study clinical team. Intranasal administrations will occur 2-4 times daily, coordinated around routine nursing care, for 7 consecutive days.
Receives: Other: Intranasal Fresh Mother's Own Milk (iF-MOM)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Incidence of Any-Grade Intraventricular Hemorrhage (Papile Grades I-IV)

    Presence of any intraventricular hemorrhage (IVH), Papile Grades I-IV, assessed on the standardized cranial ultrasound performed at 4-7 days of life.

    Measured: 4 to 7 days of life

Secondary outcomes (5)
  1. Incidence of Severe Intraventricular Hemorrhage (Papile Grades III-IV)

    Presence of severe IVH, defined as Papile Grade III or IV, on the day 4-7 cranial ultrasound or subsequent clinically indicated cranial ultrasound imaging.

    Measured: From the initial cranial ultrasound performed at 4-7 days of life through hospital discharge, up to 6 months of life

  2. Progression of Intraventricular Hemorrhage

    Worsening of IVH grade on repeat cranial ultrasound compared with the initial day 4-7 cranial ultrasound.

    Measured: From the initial cranial ultrasound performed at 4-7 days of life through hospital discharge, up to 6 months of life

  3. Post-Hemorrhagic Ventricular Dilatation Requiring Intervention

    Development of post-hemorrhagic ventricular dilatation requiring clinical or neurosurgical intervention, including ventriculoperitoneal shunt when applicable.

    Measured: From the initial cranial ultrasound performed at 4-7 days of life through hospital discharge, up to 6 months of life

  4. All-Cause Mortality

    Death from any cause occurring before hospital discharge.

    Measured: From birth until death or hospital discharge, whichever occurs first, assessed up to 6 months of life

  5. Incidence and Severity of Adverse Events Associated With Intranasal iF-MOM Administration

    Adverse events occurring during or after iF-MOM administration will be recorded and classified as mild, moderate, severe, or serious according to the prespecified study safety criteria.

    Measured: During the 7-day intervention period

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted10 Sep 2026
  2. Study startOct 2026 (estimated)
  3. Primary completionOct 2027 (estimated)
  4. Study completionApr 2028 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Prevention
Allocation
Not applicable
Intervention model
Single group
Model description
Eligible infants are prospectively assigned to receive intranasal fresh mother's own milk during the first 7 days of life. There is no concurrently assigned control arm. Outcomes will be compared with eligible historical controls cared for at the same two neonatal intensive care units between 2020 and 2025 using propensity score weighting. The primary cranial ultrasound outcome will be interpreted by a reviewer blinded to prospective intervention versus historical-control status.
Masking
None (open label)
Enrolment
67 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07812922
Sponsor's protocol ID
iF-MOM-IVH
Acronym
iF-MOM-IVH
Status last verified
Sep 2026
First submitted
31 Aug 2026
Last updated
10 Sep 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Nagy Z, Obeidat M, Mate V, Nagy R, Szanto E, Veres DS, Koi T, Hegyi P, Major GS, Garami M, Gasparics A, Te Pas AB, Szabo M. Occurrence and Time of Onset of Intraventricular Hemorrhage in Preterm Neonates: A Systematic Review and Meta-Analysis of Individual Patient Data. JAMA Pediatr. 2025 Feb 1;179(2):145-154. doi: 10.1001/jamapediatrics.2024.5998.

    PubMed 39786414
  • Sonmez Demir G, Ozdemir OM, Turgut M, Pekal Y, Koyuncu E, Gungor O, Ergin H. Impact of Intranasal Administration of Fresh Breast Milk in Very Low Birth Weight Infants With Germinal Matrix-Intraventricular Hemorrhage. Cureus. 2025 Mar 11;17(3):e80416. doi: 10.7759/cureus.80416. eCollection 2025 Mar.

    PubMed 40213722
  • Gallipoli A, Unger S, El Shahed A, Fan CS, Signorile M, Wilson D, Hoban R. Outcomes after intranasal human milk therapy in preterm infants with intraventricular hemorrhage. J Perinatol. 2025 Feb;45(2):202-207. doi: 10.1038/s41372-024-02147-3. Epub 2024 Oct 9.

    PubMed 39384614
  • Hoban R, Gallipoli A, Signorile M, Mander P, Gauthier-Fisher A, Librach C, Wilson D, Unger S. Feasibility of intranasal human milk as stem cell therapy in preterm infants with intraventricular hemorrhage. J Perinatol. 2024 Nov;44(11):1652-1657. doi: 10.1038/s41372-024-01982-8. Epub 2024 Apr 30.

    PubMed 38688998
  • Keller T, Korber F, Oberthuer A, Schafmeyer L, Mehler K, Kuhr K, Kribs A. Intranasal breast milk for premature infants with severe intraventricular hemorrhage-an observation. Eur J Pediatr. 2019 Feb;178(2):199-206. doi: 10.1007/s00431-018-3279-7. Epub 2018 Nov 1.

    PubMed 30386923

Questions about this trial

What is this clinical trial studying?

A study testing Intranasal Fresh Mother's Own Milk (iF-MOM) in people with Intraventricular Hemorrhage and Premature Birth, run by University of Manitoba.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 10 Sep 2026. Status can change between updates, so confirm with the study contact before making plans.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Michael Narvey (204-899-6845, mnarvey@hsc.mb.ca), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Incidence of Any-Grade Intraventricular Hemorrhage (Papile Grades I-IV) (time frame: 4 to 7 days of life). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07812922, which also lists 5 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 10 Sep 2026.

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